Obstetric hemorrhage is still a significant cause of maternal morbidity and mortality. Prevention, early recognition, and prompt intervention are the keys to minimizing complications. Resuscitation can be inadequate because of under-estimation of blood loss and misleading maternal response. A young woman may maintain a normal blood pressure until sudden and ...

Exposure of the fetus to indomethacin produces constriction of the fetal ductus arteriosus (DA) and hypoxia in the avascular muscle media of the vessel wall. Hypoxia induces cell death, which increases the incidence of patent DA in the newborn period. We used a fetal sheep model to determine the factors ...

Fetal cells in maternal blood represent the future of prenatal screening and diagnosis. The possibility of analyzing fetal cells recovered from maternal blood could provide screening and diagnostic protocols characterized by high sensitivity and specificity with no direct risk to the developing fetus. Years of investigation have thus far not ...

The pregnant llama (Lama glama) has walked for millions of years through the thin oxygen trail of the Andean altiplano. We hypothesize that a pool of genes has been selected in the llama that express efficient mechanisms to withstand this low-oxygen milieu. The llama fetus responds to acute hypoxia with ...

To test the hypothesis that the placental fractional moving blood volume is different with advancing gestational age (GA), we assessed the vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) of the placenta in normal pregnancy by using three-dimensional (3-D) power Doppler ultrasound (US). We enrolled 100 healthy pregnant ...

BACKGROUND: Enumeration of fetal red blood cells (RBCs) is important in the management of fetomaternal hemorrhage (FMH), particularly in situations of Rh incompatibility. METHODS: We evaluated results from three institutions using the flow cytometric method (FCM) to detect fetal RBCs based on the anti-hemoglobin F (HbF) monoclonal antibody method. RESULTS: ...

The hypothesis that nitric oxide plays a key role in the regulation of adrenal blood flow and plasma concentrations of cortisol and catecholamines under basal and hypoxaemic conditions in the llama fetus was tested. At 0.6-0.8 of gestation, 11 llama fetuses were surgically prepared for long-term recording under anaesthesia with ...

Complete fetal bladder outlet obstruction was first diagnosed in a fetus at 13.5 weeks. After sequential vesicocentesis had shown good renal function, a vesico-amniotic shunt was inserted at 17 weeks with a Rodeck catheter. The procedure was successful and amniotic fluid volume re-accumulated to normal levels. A detailed scan at ...

The aim of this study was to assess the value of the middle cerebral artery (MCA) Doppler time-averaged mean velocity (TAMV) for the prediction of fetal anaemia in at-risk cases without ultrasound evidence of hydrops. The study included 35 pregnant women with non-hydropic fetuses and with known red cell antibodies, ...

Fetal stem cells transplants depend on nucleated cells from fetal blood. This study was a prospective randomized trials to compare the collection of fetal blood by gravity into a bag containing anticoagulant, before and after delivery of the placenta. The obstetric and the newborn characteristics in the two group were ...

BACKGROUND: The quantification of fetal cells in the maternal circulation remains an important goal to determine the amount of anti-D necessary to prevent active immunization of a D- mother giving birth to a D+ baby. Underestimation of fetomaternal hemorrhage (FMH) results in inefficient anti-D prophylaxis and maternal immunization; overestimation of ...

OBJECTIVE: Allogenic transplantation of umbilical cord blood (UCB) from HLA-identical siblings is a therapeutic concept of increasing importance. Prenatal HLA typing results can provide important information as to whether the UCB should be collected. Therefore, we tested the suitability of two methods based on polymerase chain reaction (PCR) for low-resolution ...

Preeclampsia, a common complications of pregnancy, is associated with an increase in the concentration of leptin in the maternal blood, which precedes the clinical onset of the disease. This review addresses the potential sources of leptin and considers the possible consequences, although at present these are entirely conjectural. The placenta ...

OBJECTIVE: This study was designed to compare the values of blood gases in local scalp blood, obtained by scalp blood sampling, with direct measurements of fetal preductal arterial blood in fetal sheep. METHODS: Six fetal lambs were catheterized in the brachial artery and vein. Maternal oxygenation was reduced in steps ...

OBJECTIVE: To determine the effects of magnesium sulfate therapy on maternal and fetal osmolality in pre-eclampsia. METHODS: A total of 34 pre-eclamptic women and 22 normal pregnant women participated in the study. Venous blood was drawn upon admission to the labor and delivery unit. Pre-eclamptic patients received standard magnesium sulfate ...

Although it is established that the fetus can successfully withstand a single, acute hypoxaemic challenge during gestation, little is known about what effects prevailing adverse intrauterine conditions might have on the fetal response to acute hypoxaemia. The aims of this study were therefore: (1) to characterise the effects of prevailing ...

Clinical depression, diagnosed in 5-15% of women during pregnancy, increases the risk of negative pregnancy outcomes including an increased incidence of low birth weight newborns and preterm delivery. Fluoxetine, a selective serotonin reuptake inhibitor, is often prescribed to treat depression due to its efficacy, high margin of safety, and mild ...

OBJECTIVE: This study aimed to evaluate the hemodynamic patterns of the proximal (M1) and distal (M2) portions of the middle cerebral artery, during different fetal behavioral states. DESIGN: The study included 20 normal singleton pregnancies at between 36 and 40 weeks of gestation. After identification of the fetal behavioral state ...

Large amounts of amniotic fluid (AF) are swallowed in late gestation. AF is the most accessible fetal compartment and provides a possible paraplacental route for the therapeutic administration of hormones and nutrients to the fetus. We therefore wished to investigate the fate of the predominant fetal growth factor, IGF-I, administered ...

OBJECTIVES: In order to determine factors influencing the flow rate trough a created defect in human fetal membranes, an ex vivo set-up was used with fetal membranes collected from patients undergoing Caesarean section at term. METHODS: The membranes were secured at the bottom of a plastic tube and traumatised with ...

OBJECTIVES: To confirm the recent report of the culture of single clones of fetal progenitor cells from maternal blood. METHODS: Hemopoietic progenitor cells were cultured from 16 blood samples obtained from women pregnant with a male singleton fetus. Single colonies were isolated by micro-manipulation and examined by multiplex real-time PCR. ...

The ability of neonatal and maternal erythrocytes to produce reactive oxygen species (ROS) in response to oxidative stress was investigated using the chemiluminescence probe Cypridina luciferin analogue. The chemiluminescence probe, based on 2-methyl-6-[p-methoxyphenyl]-3,7-dihydro-imidazo[1,2-alpha]pyrazin-3-one (MCLA), is highly specific and sensitive to superoxide anion (O(2)(-)) and singlet oxygen (1O(2)). Blood from 11 ...

Different approaches have been proposed for the enrichment of fetal nucleated red blood cells (NRBC) from maternal blood as an alternative way to obtain fetal tissue for non-invasive prenatal diagnosis. The main purpose of this study was to compare two of our monoclonal antibodies (2E11.3 and 2B7.4 mAbs) with the ...

To isolate fetal cells from maternal blood, we developed a new method based on galactose-bearing conjugation. Nucleated red blood cells (NRBCs), which highly express galactose on their surface, were selectively attached to a substrate coated with a galactose-containing polymer via soybean agglutinin (SBA), a galactose-specific lectin. Cord blood samples were ...

Various strategems of complexity analysis of microvascular blood flow were carried out in several fields of medicine in the past, as such as angiology, ophthalmology and neurology. The introduction of colour-angio-mode, a special form of colour coded Doppler sonography, now makes possible to perform complexity analysis of the placental blood ...

OBJECTIVES: To evaluate the potential usefulness of noninvasive ultrasound assessment of fetal anemia in the diagnosis and management of fetuses with homozygous alpha-thalassemia-1. METHODS: We describe four pregnancies complicated by fetal homozygous alpha-thalassemia-1. They presented with ultrasound abnormalities before the development of hydrops. As part of evaluating the fetal condition, ...

The effects of fetal asphyxia on cerebral function and development, involve the transition from fetal to neonatal life. Changes in cerebral glucose metabolism may be an early postnatal indicator of fetal asphyxia. The objective is to develop an experimental lamb model involving the transition from fetal to neonatal life and ...

BACKGROUND: Many methods have been employed to obtain fetal cells from maternal blood for prenatal diagnostics, but there has been little work done that compares the efficacy of different methods. This study presents a comparison of two commonly used methods for selecting erythroblasts with selection directly from whole blood. METHODS: ...

OBJECTIVE: To evaluate the intrapartum pharmacokinetics of cefazolin, including delivery to amniotic fluid (AF) and fetal compartments, and to ascertain that adequate cefazolin concentrations are attained to exceed the mean concentration inhibiting 90% (MIC(90)) of group B streptococcus strains. METHODS: Cefazolin (1 g) was administered intravenously at five separate time ...

Superior sagittal sinus blood flow (Q(ss)) was studied over a 6-h period in nine chronically catheterized fetal sheep as a continuous measure of cerebral blood flow to determine the change in blood flow values and in measures of blood flow variability in relation to behavioural state activity. Mean Q(ss) was ...

BACKGROUND: Fetal hypoxia and/or acidosis causes redistribution of blood flow to the high-priority organs including the adrenal glands. Although this phenomenon is well described in the human cerebral and placental circulations using Doppler velocimetry, there are few reports about the adrenal glands. AIM: To clarify the gestational age-related changes in ...

OBJECTIVE: The contribution of the fetal chorioamniotic membranes (i.e. the intramembranous pathway) to the regulation and maintenance of amniotic fluid (AF) volume and composition has yet to be completely understood. Knowledge of membrane permeability properties is vital to understanding how the intramembranous pathway contributes to the overall maintenance of AF ...

Long-term loss of fetal blood can occur with fetomaternal hemorrhage, vasoprevia, or placental previa. Our objective was to determine the effects of progressive fetal blood loss over 10 days on fetal plasma erythropoietin (EPO) concentration and its relationship to arterial PO(2), hematocrit, and the volume of blood loss. Late-gestation fetal ...

Surgical treatment is usually selected for placental polyp accompanied by massive bleeding but patients wishing to conserve their fecundity require conservative management. A 35-year old nullipara was diagnosed as having placental polyp on the basis of typical episodes, and detection of placental polypeptide hormones and blood flow by Doppler ultrasonography ...

OBJECTIVE: To estimate, in maternal red blood cell alloimmunization, the diagnostic value of fetal ultrasonography and Doppler blood flow velocity in the evaluation and prediction of fetal anemia. METHODS: Literature from 1970 to 2000 was identified using general bibliographic databases (MEDLINE and EMBASE), the Cochrane Library and relevant specialist register ...

Rises in fetal adenosine during hypoxia may have a metabolic inhibitory role that helps the fetus adapt to periods of low arterial partial pressure of oxygen (P(a)O(2)). We examined the fetal cerebral hemodynamic and metabolic responses to exogenous adenosine infusion and compared this with previous studies. Six fetal sheep at ...

Chronic fetal hypoxia in fetal growth restriction due to impaired placentation is associated with centralization of blood flow to the vital organs, such as brain, heart and adrenal glands, in order to maintain oxygenation. There is a correlation between fetal hypoxemia and low impedance to blood flow in the middle ...

The non-invasive determination of fetal genetic characteristics, including blood group types, is a long-sought goal of modern genetics. Previous work on the use of fetal cells in maternal blood has been hampered by the rarity of such cells. The recent discovery of cell-tree fetal DNA in maternal blood has opened ...

OBJECTIVE:The purpose of the present study was to determine whether endotoxins (lipopolysaccharides, LPS) affect the fetal cardiovascular system in a way likely to cause brain damage. METHODS:Thirteen fetal sheep were chronically instrumented at a mean gestational age of 107 +/- 1 days. After control measurements of organ blood flow (microsphere ...

OBJECTIVE: The purpose of this study was to determine which extracorporeal membrane oxygenation (ECMO) route best approximates the normal physiologic pattern of oxygenated blood distribution in fetal lambs submerged in warm saline solution. STUDY DESIGN: Six fetal lambs ranging from 113 to 129 days of gestation were delivered by cesarean ...

The mammalian placenta is the organ through which respiratory gases, nutrients, and wastes are exchanged between the maternal and fetal systems. Thus, transplacental exchange provides for all the metabolic demands of fetal growth and development. The rate of transplacental exchange depends primarily on the rates of uterine (maternal placental) and ...

OBJECTIVE: To compare power spectral derived variability parameters from the fetal side of the placental circulation with those from the maternal side of the placental circulation, during early pregnancy. METHODS: Doppler velocity waveforms were obtained from both the umbilical and the uterine arteries in a study group of 40 pregnant ...